RHCs funded under the RHC COVID-19 Testing and Mitigation (RHCCTM) Program could apply any of the payments to COVID-19 testing, COVID-19 testing-related expenses, COVID-19 mitigation, and COVID-19 mitigation-related expenses.
- A viral test checks specimens from your nose or your mouth to find out if you are currently infected with the virus that causes COVID-19. Two types of viral tests are uses: nucleic acid amplification tests (NAATs) and antigen tests.1
- Viral tests can also be used as screening tests to reduce transmission of SARS-CoV-2 by identifying infected (symptomatic and exposed) persons who need to isolate from others.
- Viral tests can be performed in the following settings including, but not limited to:
- Laboratory (complete laboratory and/or partial laboratory cycle (i.e., phases))
- Testing site (onsite and/or off-site/third party COVID-19 testing with active RHC involvement in the administration and oversight)
- At home or anywhere else (prescription and/or non-prescription (i.e., home collection; direct-to-consumer; over-the-counter)). 2,3
1 Centers for Disease Control. (2021).
2 U.S. Food and Drug Administration. (2021).
3 U.S. Department of Health and Human Services, Office of the Inspector General. (2021).
- Antibody or serology tests look for antibodies in your blood to determine if you had a past infection with the virus that causes COVID-19.
- Antibody tests should not be used to diagnose a current infection with the virus that causes COVID-19, except in instances in which viral testing is delayed.
- An antibody test may not show if you have a current infection because it can take 1-3 weeks after the infection for your body to make antibodies.4
4 Centers for Disease Control. (2021).
- Additional testing information is available from the Department of Health and Human Services (HHS).
- Additional testing information and resources for health care workers are available from the CDC.
- Additional testing information is available from the FDA.
Case investigation is the process of working with a person (patient) who has been diagnosed with COVID-19, and includes, but is not limited to:
- Discuss patient test result or diagnosis
- Assess patient symptom history and health status
- Provide instructions and support for self-isolation and symptom monitoring
- Identification of people (contacts) who may have been exposed to COVID-19
Additional case investigation information and resources for health departments are available from the CDC.
Contact tracing is the process of notifying people (contacts) of their potential exposure to SARS-CoV-2, the virus that causes COVID-19 and includes, but is not limited to:
- Provide information about the virus
- Discuss their symptom history and other relevant health information
- Instructions for self-quarantine and monitoring for symptoms
- Support and referrals to testing, clinical services, and other essential support services
Testing asymptomatic persons without recent known or suspected exposure to SARS-CoV-2 for early identification, isolation, and disease prevention. Screening testing as a prevention strategy can improve detection of SARS-CoV-2. Widespread testing (e.g., within cohorts) with rapid isolation of infected individuals may facilitate reopening of businesses, communities, and schools (e.g., in-person instruction in K-12 schools) with less risk of a surge in local cases.
Post-COVID conditions can occur in patients who had varying degrees of illness during acute infection, including those who had mild or asymptomatic infections. Post-COVID conditions are referred to as a wide variety of names, including post-acute COVID-19, long-term effects of COVID, long COVID, post-acute COVID syndrome, chronic COVID, long-haul COVID, late sequelae, and others, as well as the research term post-acute sequalae of SARS-COV-2 infection (PASC).
Post-COVID conditions can be considered a lack of return to a usual state of health following acute COVID-19 illness. It might also include development of new or recurrent symptoms that occur after the symptoms of acute illness have resolved. Post-COVID conditions include, but are not limited to:
- Health consequences that are present more than 4 weeks after infection with SARS-CoV-2.3
- Multiorgan system effects of COVID-19
- Multisystem inflammatory syndrome (MIS)
- Autoimmune conditions
- Longer effects of COVID-19 treatment or hospitalization
- Long COVID
The best way to prevent long-term complications is to prevent COVID-19. There are ways to mitigate patient post-COVID conditions and lessen symptoms over time. You are encouraged to provide options for managing or treating post-COVID conditions and symptoms. Post-COVID mitigation includes, but is not limited to:
- Education, rehabilitation, prevention, treatment, and support services including support for activities of daily living
- Post-acute COVID care clinics
- Post-acute COVID patient appointments
- Resources for support
- Survivor support groups
- COVID-19 aftercare
3 The time frame of more than four weeks provides a rough approximation of effects that occur beyond the acute period, but the timeframe might change as the CDC learns more.
- Healthy operations
- Prepare for when someone gets sick
- Testing promotion and confidence building
- Isolation and precautions for people with COVID-19
- Post-COVID conditions
Promote behaviors that prevent the spread of COVID-19, which includes, but is not limited to:
- Healthy hygiene practices
- Stay at home when sick
- Practice physical distancing to lower the risk of disease spread
- Referrals to testing, clinical services, and support services
- Cloth face coverings (i.e., masks)
- Clean and disinfect
- Ensure ventilation systems operate properly and increase circulation of outdoor air
- Ensure all water systems are safe to use
- Modify layouts to promote social distance of at least 6 feet between people
- Install physical barriers and guides to support social distancing if appropriate
Supplies to provide COVID-19 testing include, but are not limited to:
- Swabs
- Storage (e.g., refrigerator, freezer, temperature-controlled cabinet)
- Storage unit door safeguards (e.g., self-closing door hinges, door alarms, door locks)
- Sharps disposal containers
- Temperature monitoring equipment
- Test kits
Personal protective equipment, commonly referred to as "PPE", includes, but is not limited to:
- Facemasks
- Eye protection
- Gowns
- Gloves
- N95 and other respirators
- Planning for implementation of a COVID-19 testing program
- Training providers and staff on COVID-19 testing procedures
- Hiring providers and staff to carry out COVID-19 testing procedures
- Reporting data to HHS on COVID-19 testing activities
- Expenses to secure and maintain adequate personnel to carry out COVID-19 testing if the activity generating the expense and/or the expenses were necessary to secure and maintain adequate personnel, such as:
- Offering hiring bonuses and retention payments
- Overtime pay
- Mental health and stress management resources
- Other fringe benefits
- Incentive pay
- Childcare
- Transportation
- Temporary housing
- Building or construction of temporary structures
- Leasing of properties
- Retrofitting facilities as necessary to support COVID-19 testing
- Planning for implementation of a COVID-19 mitigation program
- Training providers and staff on COVID-19 mitigation activities
- Hiring providers and staff to carry out COVID-19 mitigation activities
- Reporting data to HHS on COVID-19 mitigation activities
- Expenses to secure and maintain adequate personnel to carry out COVID-19 mitigation if the activity generating the expense and/or the expenses were necessary to secure and maintain adequate personnel, such as:
- Offering hiring bonuses and retention payments
- Overtime pay
- Mental health and stress management resources
- Other fringe benefits
- Incentive pay
- Childcare
- Transportation
- Temporary housing
- Building or construction of temporary structures as necessary to support mitigation activities
- Leasing of properties as necessary to support mitigation
- Retrofitting facilities as necessary to support mitigation and infection control
CDC recommends a layered approach to reduce exposures to SARS-CoV-2 and other infectious diseases which includes using multiple mitigation strategies, including but not limited to recommendations found in the CDC Guidelines for Environmental Infection Control in Health-Care Facilities (PDF).
Digital technologies to strengthen the core capacity to support the public-health response to COVID-19 including, but not limited to:
- Population surveillance
- Case identification
- Contact tracing
- Evaluation of interventions on the basis of mobility data and communication with the public
Unallowable expenses
RHC CTM Program funds could NOT be used for direct provider-to-patient vaccine administration (i.e., shot-in-arm). Direct provider-to-patient vaccine administration does NOT include associated costs and add-on services necessary to facilitate or in conjunction with the direct provider-to-patient vaccine administration.
The following HRSA programs covered the cost of vaccine administration:
- HRSA COVID-19 Uninsured Program: covered the costs for COVID-19 services provided to anyone without health insurance.
- HRSA COVID-19 Coverage Assistance Fund: covered the costs of administering COVID-19 vaccines to patients whose health insurance does not cover vaccine administration fees, or does but typically has patient cost sharing.
*For allowable expenses under the Rural Health Clinic COVID-19 Testing Program, visit the RHCCT Program page.